BACKGROUND Nephritic syndrome(NiS)is a major indicator of serious renal diseases necessitating kidney biopsies for histopathological evaluations,but due to the lack of comprehensive reviews in the literature,the curre...BACKGROUND Nephritic syndrome(NiS)is a major indicator of serious renal diseases necessitating kidney biopsies for histopathological evaluations,but due to the lack of comprehensive reviews in the literature,the current understanding of the syndrome and its significance is limited.AIM To collect all the evidence retrievable from the literature on the diagnoses made on the renal biopsies performed for NiS as the indication to the procedure.METHODS A literature search was conducted to find studies reporting final diagnoses on renal biopsies in NiS patients.Data were pooled and analyzed with stratifications on age and regions.Meta-analyzes were performed using Stata v.9.RESULTS Overall,26414 NiS patients from the total number of 96738 kidney biopsy diagnoses reported by 47 studies from 23 countries from all continents(except sub-Saharan Africa)were found and analyzed.NiS was the indication for renal biopsy in 21%of the patient populations across the reviewed studies.Immunoglobulin A(IgA)nephropathy was the single most frequent diagnosis in these patients(approximately 38%)followed by lupus nephritis(approximately 8%)and Henoch Schönlein purpura(approximately 7%).IgA nephropathy was the most frequent diagnosis reported for the NiS patients from the East Asia,comprising half of all the cases,and least prevalent in South Asia.Considering the age subgroups,adult(vs pediatric or elderly)patients were by far the most likely age group to be diagnosed with the IgA nephropathy.A myriad of such regional and age disparities have been found and reported.CONCLUSION As the indication for renal biopsy,NiS represents a very distinctive epidemiology of final renal disease diagnoses compared to the other major syndromes.展开更多
In the occurrence and development of glomerulonephritis, proteinuria is themain manifestation, which is easily recurrent but not easily got rid of in a short period of time. It may remain even after disappearance ... In the occurrence and development of glomerulonephritis, proteinuria is themain manifestation, which is easily recurrent but not easily got rid of in a short period of time. It may remain even after disappearance of the general symptoms. In some patients, there are no symptoms and signs at all in the initial stage, except proteinuria, the only distinct manifestation. Prof. Ye Chuanhui, from Chengdu University of Traditional Chinese Medicine, has accumulated rich experience for treating this disorder, which is introduced in the following.……展开更多
In this editorial,we comment on the article by Meng et al published in the World Journal of Clinical Cases.We comprehensively review immunoglobulin A nephro-pathy(IgAN),including epidemiology,clinical presentation,dia...In this editorial,we comment on the article by Meng et al published in the World Journal of Clinical Cases.We comprehensively review immunoglobulin A nephro-pathy(IgAN),including epidemiology,clinical presentation,diagnosis,and management.IgAN,also known as Berger's disease,is the most frequent type of primary glomerulonephritis(GN)globally.It is mostly found among the Asian population.The presentation can be variable,from microscopic hematuria to a rapidly progressive GN.Around 50%of patients present with single or recurring episodes of gross hematuria.An upper respiratory infection and tonsillitis often precede these episodes.Around 30%of patients present microscopic hematuria with or without proteinuria,usually detected on routine examination.The diagnosis relies on having a renal biopsy for pathology and immunofluorescence microscopy.We focus on risk stratification and management of IgAN.We provide a review of all the landmark studies to date.According to the 2021 KDIGO(kidney disease:Improving Global Outcomes)guidelines,patients with non-variant form IgAN are first treated conservatively for three to six months.This approach consists of adequate blood pressure control,reduction of proteinuria with renin-angiotensin system blockade,treatment of dyslipidemia,and lifestyle modifications(weight loss,exercise,smoking cessation,and dietary sodium restrictions).Following three to six months of conservative therapy,patients are further classified as high or low risk for disease progression.High-risk patients have proteinuria≥1 g/d or<1 g/d with significant microscopic hematuria and active inflammation on kidney biopsy.Some experts consider proteinuria≥2 g/d to be very high risk.Patients with high and very high-risk profiles are treated with immunosuppressive therapy.A proteinuria level of<1 g/d and stable/im-proved renal function indicates a good treatment response for patients on immu-nosuppressive therapy.展开更多
The Tashisayi nephrite deposit is located in South Altyn Tagh.in Qiemo County,Xinjiang Province,northwest China.It is a recent discovery in the vast,well-known Kunlun-Altyn nephrite belt distributed along the south of...The Tashisayi nephrite deposit is located in South Altyn Tagh.in Qiemo County,Xinjiang Province,northwest China.It is a recent discovery in the vast,well-known Kunlun-Altyn nephrite belt distributed along the south of the Tarim Basin,producing more than half of the nephrite from the whole belt in 2017.Field investigations revealed that it is a dolomitic marble-related(D-type)nephrite deposit,but little is known about its age of formation and relationships between the granites and marble.Here we report field investigations,petrography of the neph rite,as well as petrography,geochemistry,geochronology of the zoisite-quartz altered intrusive rock and adjacent granites.An A-type granite is identified with a SHRIMP U-Pb zircon age of 926±7 Ma,suggesting it was emplaced in an extensional tectonic environment at that time.The altered intrusive rock has a cluster of U-Pb zircon age of 433±10 Ma.with similar trace element features to the A-type granite,suggesting it was formed in an extensional regime at this later time.Nephrite formed because of the metasomatism of dolomite marble by hydrothermal fluids.It is inferred that Ca^2+was released from the dolomitic marble by metasomatism forming Ca-rich fluids,which caused alteration of both the intrusive rocks(6.00-8.22 wt.%CaO)and granite(1.76-3.68 wt.%CaO)near the nephrite ore bodies.It is also inferred that Fe^2+from the granite migrated towards the dolomite marble.The fluids gave rise to the formation of Ca-minerals.such as zoisite,in the nephrite and altered intrusive rock,and epidote in the granite.Based on the contact relationships.similarity in hydrothermal processes,and consumption of Ca^2+,the Tashisayi nephrite is considered to have formed at the same time as the alteration of the intrusive rocks,i.e.~433 Ma.The geochronological similarity(~926 Ma.433 Ma)of South Altyn and North Qaidam may suggest that tectonically they belong to one single complex in the past,which was offset by the Altyn Tagh fault(ATF).The similar formation ages of the nephrites from Altyn Tagh(433 Ma)and the previously studied areas of West Kunlun(378-441 Ma)and East Kunlun(416 Ma)indicate that these nephrites formed during the closure of Proto-Tethys and in the accompanving post-collisional.extensional environment.展开更多
It is shown that on a small (200 km<sup>2</sup>) massif area two extensive groups of metallic (Cr, Ni, Cu, Au, Ag, Pt, Pd, Ru, Os, Ir) and non-metallic (diamond, nephrite, jewelry and ornamental rodingites...It is shown that on a small (200 km<sup>2</sup>) massif area two extensive groups of metallic (Cr, Ni, Cu, Au, Ag, Pt, Pd, Ru, Os, Ir) and non-metallic (diamond, nephrite, jewelry and ornamental rodingites, chrysolite) types of minerals are spatially and genetically combined. They are grouped into 4 ore-forming types of polycomponent ores: diamond-gold-platinum-metal, chromium-nickel-platinum-metal, gold-platinum-metal and chrysolite-nephrite-rodingite. Ore-formational types form a minerogenic series—the product of a single ore-forming system. The paragenetic kinship between diamonds, chrysolite, nephrite, chromite and noble metals has been established. There are main genetic characteristics that ensure the formation uniqueness of the ore-forming system: 1) chariage-thrust control of ore mineralization and multilevel dynamometamorphic ore genesis with a mechanochemical mechanism of mineral formation. Ore-controlling thrusts are structures of shallow dipping that do not cover the entire lithosphere, but only a section of the earth’s crust;2) carbon fluid, mainly of carbonyl form, which has subjected all types of the ophiolite complex rocks of the Ospa-Kitoy node to intensive transformation, has a crustal mechanochemical, not mantle origin;3) a strong paragenetic (“hybrid”) petrological-mineral-geochemical relation occurring between minerals groups of metallic and non-metallic types is a consequence of the participation in the ore genesis processes of a large variety in different material composition of rocks petrotypes, representing a section of the Earth’s crust in the considered part of the East Sayan ophiolite belt.展开更多
Acute post-streptococcal glomerulonephritis(APSGN)is the major cause of acute glomerulonephritis among children,especially in low-and middle-income countries.APSGN commonly occurs following pharyngitis due to the acti...Acute post-streptococcal glomerulonephritis(APSGN)is the major cause of acute glomerulonephritis among children,especially in low-and middle-income countries.APSGN commonly occurs following pharyngitis due to the activation of antibodies and complements proteins against streptococcal antigens through the immune-complex-mediated mechanism.APSGN can be presented as acute nep-hritic syndrome,nephrotic syndrome,and rapidly progressive glomerulonephritis,or it may be subclinical.The management of APSGN is mainly supportive in nature with fluid restriction,anti-hypertensives,diuretics,and renal replacement therapy with dialysis,when necessary,as the disease is self-limiting.Congestive heart failure,pulmonary edema,and severe hypertension-induced encephalopathy might occur during the acute phase of APSGN due to hypervolemia.APSGN generally has a favorable prognosis with only a small percentage of patients with persistent urinary abnormalities,persistent hypertension,and chronic kidney disease after the acute episode of APSGN.Decreased complement levels,increased C-reactive protein,and hypoalbuminemia are associated with disease severity.Crescent formations on renal biopsy and renal insufficiency on presentation may be the predictors of disease severity and poor outcomes in APSGN in children.展开更多
文摘BACKGROUND Nephritic syndrome(NiS)is a major indicator of serious renal diseases necessitating kidney biopsies for histopathological evaluations,but due to the lack of comprehensive reviews in the literature,the current understanding of the syndrome and its significance is limited.AIM To collect all the evidence retrievable from the literature on the diagnoses made on the renal biopsies performed for NiS as the indication to the procedure.METHODS A literature search was conducted to find studies reporting final diagnoses on renal biopsies in NiS patients.Data were pooled and analyzed with stratifications on age and regions.Meta-analyzes were performed using Stata v.9.RESULTS Overall,26414 NiS patients from the total number of 96738 kidney biopsy diagnoses reported by 47 studies from 23 countries from all continents(except sub-Saharan Africa)were found and analyzed.NiS was the indication for renal biopsy in 21%of the patient populations across the reviewed studies.Immunoglobulin A(IgA)nephropathy was the single most frequent diagnosis in these patients(approximately 38%)followed by lupus nephritis(approximately 8%)and Henoch Schönlein purpura(approximately 7%).IgA nephropathy was the most frequent diagnosis reported for the NiS patients from the East Asia,comprising half of all the cases,and least prevalent in South Asia.Considering the age subgroups,adult(vs pediatric or elderly)patients were by far the most likely age group to be diagnosed with the IgA nephropathy.A myriad of such regional and age disparities have been found and reported.CONCLUSION As the indication for renal biopsy,NiS represents a very distinctive epidemiology of final renal disease diagnoses compared to the other major syndromes.
文摘 In the occurrence and development of glomerulonephritis, proteinuria is themain manifestation, which is easily recurrent but not easily got rid of in a short period of time. It may remain even after disappearance of the general symptoms. In some patients, there are no symptoms and signs at all in the initial stage, except proteinuria, the only distinct manifestation. Prof. Ye Chuanhui, from Chengdu University of Traditional Chinese Medicine, has accumulated rich experience for treating this disorder, which is introduced in the following.……
文摘In this editorial,we comment on the article by Meng et al published in the World Journal of Clinical Cases.We comprehensively review immunoglobulin A nephro-pathy(IgAN),including epidemiology,clinical presentation,diagnosis,and management.IgAN,also known as Berger's disease,is the most frequent type of primary glomerulonephritis(GN)globally.It is mostly found among the Asian population.The presentation can be variable,from microscopic hematuria to a rapidly progressive GN.Around 50%of patients present with single or recurring episodes of gross hematuria.An upper respiratory infection and tonsillitis often precede these episodes.Around 30%of patients present microscopic hematuria with or without proteinuria,usually detected on routine examination.The diagnosis relies on having a renal biopsy for pathology and immunofluorescence microscopy.We focus on risk stratification and management of IgAN.We provide a review of all the landmark studies to date.According to the 2021 KDIGO(kidney disease:Improving Global Outcomes)guidelines,patients with non-variant form IgAN are first treated conservatively for three to six months.This approach consists of adequate blood pressure control,reduction of proteinuria with renin-angiotensin system blockade,treatment of dyslipidemia,and lifestyle modifications(weight loss,exercise,smoking cessation,and dietary sodium restrictions).Following three to six months of conservative therapy,patients are further classified as high or low risk for disease progression.High-risk patients have proteinuria≥1 g/d or<1 g/d with significant microscopic hematuria and active inflammation on kidney biopsy.Some experts consider proteinuria≥2 g/d to be very high risk.Patients with high and very high-risk profiles are treated with immunosuppressive therapy.A proteinuria level of<1 g/d and stable/im-proved renal function indicates a good treatment response for patients on immu-nosuppressive therapy.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDA20070304)the National Science Foundation of China(Grant No.41373055)the Fundamental Research Funds for the Central Universities(Grant No.2652016126)
文摘The Tashisayi nephrite deposit is located in South Altyn Tagh.in Qiemo County,Xinjiang Province,northwest China.It is a recent discovery in the vast,well-known Kunlun-Altyn nephrite belt distributed along the south of the Tarim Basin,producing more than half of the nephrite from the whole belt in 2017.Field investigations revealed that it is a dolomitic marble-related(D-type)nephrite deposit,but little is known about its age of formation and relationships between the granites and marble.Here we report field investigations,petrography of the neph rite,as well as petrography,geochemistry,geochronology of the zoisite-quartz altered intrusive rock and adjacent granites.An A-type granite is identified with a SHRIMP U-Pb zircon age of 926±7 Ma,suggesting it was emplaced in an extensional tectonic environment at that time.The altered intrusive rock has a cluster of U-Pb zircon age of 433±10 Ma.with similar trace element features to the A-type granite,suggesting it was formed in an extensional regime at this later time.Nephrite formed because of the metasomatism of dolomite marble by hydrothermal fluids.It is inferred that Ca^2+was released from the dolomitic marble by metasomatism forming Ca-rich fluids,which caused alteration of both the intrusive rocks(6.00-8.22 wt.%CaO)and granite(1.76-3.68 wt.%CaO)near the nephrite ore bodies.It is also inferred that Fe^2+from the granite migrated towards the dolomite marble.The fluids gave rise to the formation of Ca-minerals.such as zoisite,in the nephrite and altered intrusive rock,and epidote in the granite.Based on the contact relationships.similarity in hydrothermal processes,and consumption of Ca^2+,the Tashisayi nephrite is considered to have formed at the same time as the alteration of the intrusive rocks,i.e.~433 Ma.The geochronological similarity(~926 Ma.433 Ma)of South Altyn and North Qaidam may suggest that tectonically they belong to one single complex in the past,which was offset by the Altyn Tagh fault(ATF).The similar formation ages of the nephrites from Altyn Tagh(433 Ma)and the previously studied areas of West Kunlun(378-441 Ma)and East Kunlun(416 Ma)indicate that these nephrites formed during the closure of Proto-Tethys and in the accompanving post-collisional.extensional environment.
文摘It is shown that on a small (200 km<sup>2</sup>) massif area two extensive groups of metallic (Cr, Ni, Cu, Au, Ag, Pt, Pd, Ru, Os, Ir) and non-metallic (diamond, nephrite, jewelry and ornamental rodingites, chrysolite) types of minerals are spatially and genetically combined. They are grouped into 4 ore-forming types of polycomponent ores: diamond-gold-platinum-metal, chromium-nickel-platinum-metal, gold-platinum-metal and chrysolite-nephrite-rodingite. Ore-formational types form a minerogenic series—the product of a single ore-forming system. The paragenetic kinship between diamonds, chrysolite, nephrite, chromite and noble metals has been established. There are main genetic characteristics that ensure the formation uniqueness of the ore-forming system: 1) chariage-thrust control of ore mineralization and multilevel dynamometamorphic ore genesis with a mechanochemical mechanism of mineral formation. Ore-controlling thrusts are structures of shallow dipping that do not cover the entire lithosphere, but only a section of the earth’s crust;2) carbon fluid, mainly of carbonyl form, which has subjected all types of the ophiolite complex rocks of the Ospa-Kitoy node to intensive transformation, has a crustal mechanochemical, not mantle origin;3) a strong paragenetic (“hybrid”) petrological-mineral-geochemical relation occurring between minerals groups of metallic and non-metallic types is a consequence of the participation in the ore genesis processes of a large variety in different material composition of rocks petrotypes, representing a section of the Earth’s crust in the considered part of the East Sayan ophiolite belt.
文摘Acute post-streptococcal glomerulonephritis(APSGN)is the major cause of acute glomerulonephritis among children,especially in low-and middle-income countries.APSGN commonly occurs following pharyngitis due to the activation of antibodies and complements proteins against streptococcal antigens through the immune-complex-mediated mechanism.APSGN can be presented as acute nep-hritic syndrome,nephrotic syndrome,and rapidly progressive glomerulonephritis,or it may be subclinical.The management of APSGN is mainly supportive in nature with fluid restriction,anti-hypertensives,diuretics,and renal replacement therapy with dialysis,when necessary,as the disease is self-limiting.Congestive heart failure,pulmonary edema,and severe hypertension-induced encephalopathy might occur during the acute phase of APSGN due to hypervolemia.APSGN generally has a favorable prognosis with only a small percentage of patients with persistent urinary abnormalities,persistent hypertension,and chronic kidney disease after the acute episode of APSGN.Decreased complement levels,increased C-reactive protein,and hypoalbuminemia are associated with disease severity.Crescent formations on renal biopsy and renal insufficiency on presentation may be the predictors of disease severity and poor outcomes in APSGN in children.
